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Depression: seratonin deficiency/imbalance?

Wed, 13 Jun 2007 05:17:42 GMT

clipped by: deanknows

Is There Evidence That Antidepressants Correct a Serotonin Deficiency?

Biological markers specific for depression have been elusive. Although a physician may tell a patient that a chemical imbalance causes their depression, Elliot S. Valenstein, Ph.D., has pointed out that the physician would be hard-pressed to provide any evidence to support this claim (1998). There is no test available that would demonstrate that any patient has a biological depression, as opposed to any other type, or even that such biological depressions exist.

Although proponents claim that some of the antidepressants selectively affect only one system of the brain (such as the brain serotonin system), this does not reflect current understanding of how the brain works. We know that each brain neuron receives input from tens of thousands of other neurons and, in turn, sends output to tens of thousands of other neurons.

It seems unlikely that the SSRIs only effect the serotonin systems in the brain, even initially.

Tags: psychology, depression, antidepressants

Antidepressant vs. placebo

Wed, 13 Jun 2007 04:53:33 GMT

clipped by: deanknows

Clip Source: web.archive.org

The placebo effect is itself quite strong. As many as 30% to 50% of patients who receive a placebo will recover from their depression if they are convinced they have received a real antidepressant.

This explains why so many people will protest and say, "but I took Prozac (or Paxil or whatever) and it worked miracles for me! So I know these drugs work!

But remember that 30% to 50% of mildly to moderately depressed patients will also recover if they are given a placebo--so how do we know these aren't just placebo responses? I

In nearly all drug company studies of new (or old) antidepressants, all patients are first placed on a placebo for a one or two week period.

Those who show an improvement in depression are removed from the study.

In this way, drug companies remove the "placebo responders:" before the actual study begins. This is like playing with a stacked deck,

because it creates a bias in which it will appear that the drug is better than placebo

Tags: psychology, antidepressants, depression

Knowledge of behavioral psychology

Wed, 08 Nov 2006 19:32:01 GMT

clipped by: deanknows

Clip Source: web.archive.org

But I am speculating as well. There not much solid knowledge about anything yet in the behavioral sciences. Many people are not aware of this, though. They think that they or some other expert "knows" something.

So when you ask an expert a question, she or he will usually try to provide an intelligent-sounding answer, instead of simply saying, "Actually, I don't know the answer."

For example, Freud made all sorts of claims about the causes of things. He claimed there was an id, an ego, and a superego. People naively think that these three parts of the mind actually "exist." But Freud was just speaking in metaphors.

Furthermore, few, if any, of his claims about the impact of childhood experiences on emotional problems such as depression or anxiety have ever been validated through research.

Tags: psychology, behavior, knowledge

Ten common self defeating beliefs

Tue, 07 Nov 2006 20:57:48 GMT

clipped by: deanknows
clipper's remarks: I think I have pretty much all of these beliefs.

Clip Source: web.archive.org

Here are just a few of the self-defeating beliefs that lead to depression, anxiety or anger. Are any of them are similar to the way you sometimes think and feel?

Ten Common Self-Defeating Beliefs
emotional perfectionism	I should always feel happy, confident, and in control of my emotions.
emotophobia	I should never feel angry, anxious, inadequate, jealous or vulnerable.
conflict phobia	People who love each other shouldn't fight.
entitlement	People should be the way I expect them to be.
low frustration tolerance	I should never be frustrated. Life should be easy.
performance perfectionism	I must never fail or make a mistake.
perceived perfectionism	People will not love and accept me as a flawed and vulnerable human being.
fear of failure	My worthwhileness as a human being depends on my achievements (or my intelligence, status, or attractiveness).
fear of disapproval or criticism	I need everybody's approval to be worthwhile.
fear of rejection or being alone	If I'm alone, then I'm bound to feel miserable and unfulfilled. If I'm not loved, then life is not worth living.

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Tags: beliefs, psychology, depression

How to be successful at anything

Mon, 06 Nov 2006 11:21:06 GMT

clipped by: deanknows

Clip Source: web.archive.org

Technique #15: Secrets of Unlimited Success Forever.

While I'm at it, I thought you might like to hear about how to become an incredible success in college and beyond.

First, hard, consistent work is desirable, but not really sufficient. Lots of people get good grades. What characterizes the people who go on to become super-stars?

Well, I think I have two pieces of potentially useful information. Once you've learned the basics, it can be helpful to specialize in something. Really pour yourself into one narrow area that interests you. As it turns out, it isn't that hard to become leading edge in that area, and to get ahead of the rest of the pack.

The people who become famous are usually like laser beams. They focus on one specific thing. Like Jerry Rice, who focused on being the best wide receiver he could be.

For example, I alluded to my research on brain chemistry, and how I won an important award. I focused at the time on computer simulation techniques. I worked with some of the top people in the world, but they were not psychiatrists. They were basic scientists from other disciplines.

Pretty soon, I knew far more about computer simulation of brain chemistry than anyone else in the world. The main reason for that is that I was the only one who knew how to do it. There wasn't any other psychiatrists on the surface of the earth who had any idea about it at all.

I kind of set my own creative path and went down it, gung ho. I still do the same thing. I've done the same thing my whole career.

For example, I do workshops for mental health professionals. Not too many people do that, but there are some. I pour every ounce of creative energy into my teaching. I work on it relentlessly, always trying to come up with new creative ideas.

I try them out. Some bomb. Others work well, and I incorporate them in future workshops.

Tags: psychology, advice

How to talk when you're shy

Mon, 06 Nov 2006 05:08:34 GMT

clipped by: deanknows
clipper's remarks: Shy guy responding nondefensively to a critic

Clip Source: web.archive.org

Comment: This is a really good effort, but still sounds defensive or a bit weak in places. For example, you write:

Negative Person: Well, I hate to say it but you�re not going to make any friends tonight and you�ll be sleeping alone tonight and probably for a long time.

Me: Well, I haven�t done well tonight but I�ve learned a little and maybe I can use what I�ve learned at the next party I go to.

This is weak because you didn�t really learn much at the party, in all likelihood, that will change your life anytime soon. So instead, I would revise the Me response like this:

Me: Well, you�re absolutely right. I haven�t done well tonight and this is typical of what�s going on in my life in general. I don�t seem to be very good at relating to people in social situations, or even when I get to know them well. Maybe you can tell me what I�m doing wrong? I would love to learn from you. Obviously, I have a lot to learn.

In addition, I wanted to mention that your criticisms of me have a sharp edge, a bit of a bite to them. I�m wondering if I�ve turned you off in some way, and if you�re annoyed with me? Please tell me about it if I have, because that could be part of the problem also.

Notice, Derek, that this response differs from yours in four crucial respects.

It is not defensive but you use the Disarming Technique to find truth in what the critic says.

You use Stroking and express positive feelings about the critic.

You use Inquiry and ask for more information.

You use Feeling Empathy and ask if the critic is annoyed with you.

Tags: shyness, depression, psychology

Shyness

Mon, 06 Nov 2006 04:15:10 GMT

clipped by: deanknows

Clip Source: web.archive.org

I once treated a very likeable but painfully shy young scientist from India named Roger. Roger was extremely self-conscious whenever he was out in public and he was convinced others noticed how awkward he felt. Grocery stores were especially terrifying for Roger, especially standing in line waiting to check his groceries. He was convinced that Americans were very outgoing and sociable and that they flirted and made jokes and chuckled together while waiting to check their groceries. He thought nearly all Americans were like talk show hosts like David Letterman or Jay Leno--outgoing and chatty and humorous.

Roger felt incredibly pressured to behave in the same outgoing way when he was in grocery store lines, but he couldn't think of anything clever or witty to say, so he would just stare at the floor anxiously hoping not to be noticed. When he got up to check his groceries, he would pay and leave as quickly as possible, telling himself he was a failure and feeling convinced that everyone had noticed how shy and awkward he was.

Roger also felt convinced that Americans looked down on him because of his long hair. Whenever he walked down the street or stood in line at a fast food place like McDonald's he would stare at the floor feeling very self-conscious and annoyed about the "fact" that people were staring at him in a judgmental way.

Every now and then Roger would get so irritated that he would look up and give someone a dirty look. This shocked people who would look upset. The shocked looked on their faces convinced him that they really were staring at him and he felt he had caught them in the act, so to speak! So Roger's experience appeared to confirm his negative thoughts--even though his negative thoughts were not at all valid. This is another example of how these irrational thoughts can act as self-fulfilling prophecies.

Tags: shyness, psychology

Good vs. Evil and Moral Absolutes

Mon, 06 Nov 2006 04:02:13 GMT

clipped by: deanknows

Clip Source: web.archive.org

The problem with absolutes is that they tend to be used for evil. For example, Hitler was convinced there were absolutes of good and evil, superior and inferior. He used this to justify the holocaust.

Value systems are ultimately not right or wrong, but stipulations we make. Suppose, for example, that I have a value system that says that people who achieve more are superior human beings. They are more worthwhile. A great many of the people who suffer from depression and anxiety feel this way. You cannot prove or disprove the idea that great achievers are "superior" human beings. You can only say, what are the advantages and disadvantages of thinking this way? How will it help me, and how will it hurt me?

In my experience, aggression is nearly always in the name of God, or some other equally rigid belief system. Sadistic aggression activities are almost always justified in terms of some absolute value system. For example, some people reason that they can beat up gay people, because gay people are absolutely immoral and against God's will in some way. Very few people will say, "I beat up gay people because I enjoy sadistic activities." Aggression is nearly always rationalized, and absolute value systems are need to justify extreme sadism. Like the Holy Wars in the middle ages. Why did they murder people and burn them alive? Because they enjoyed it. But it was always justified as being in the name of God. Sadistic people nearly always have the conviction they are morally superior to others.

Some people base their self-esteem on intelligence, on looks, on charm. They insist that people with these qualities REALLY ARE better than others. Usually, these people are suffering from inferiority or depression, insisting others are better than they are.

These rigid value systems lead to all kinds of weird implications. Some serial killers have been attractive, charming, and intelligent. Can you imagine meeting Ted Bundy, a handsome and shrewd, charming man.

Tags: philosophy, morals

Wittgenstein's Philosophical investigations

Mon, 06 Nov 2006 01:43:45 GMT

clipped by: deanknows

Clip Source: web.archive.org

I don't think he would agree that there are any misunderstandings for the most part in philosophy, because that would imply there is something that was not understood. The attack is on a different level, as I see it. It is more that there isn't anything to understand, or to misunderstand.

Does man have free will? This is a classic problem in philosophy. It rests on the notion that there is something called free will that we could have or not have, as if words that are nouns refer to things. This was Plato's error, that there was some kind of reality behind our notion of reality, or behind our language, and that our words only imperfectly described this reality. So when we hear words, especially nouns, we think they refer to something and have meaning. Often they do not, according to Wittgenstein.

The free will problem stems from the idea that if God exists, s/he/it knows the future. Therefore, we must do we will are fore-ordained to do. We cannot not do things, because God knows ahead of time what we will do.

Now think about the word gobbledeegazoonka. Do humans have gobbledeegazoonka? Well, that is just a sound that comes out of my mouth. I could use that words in several ways if I wanted to. I could say this word whenever I got in the car, and it might mean, "we have enough gas in the tank." It could take on other meanings as well, if people started using it in other ways. But it would refer to some thing or essence, as Plato thought, and would have no single pure meaning.

There isn't any other "meaning" to the word. There isn't any "free will" to have or not have. The question has no meaning. Questions that have no meaning do not exist, although the seem to exist, because they sound like real sentences. This is what he means by language out of gear. You rev the engine but the car won't move--because the transmission is in neutral. No matter how hard you press on the gas, the car simply will not move.

Tags: philosophy

The dating game, or how to love a woman

Sun, 05 Nov 2006 22:29:27 GMT

clipped by: deanknows

Clip Source: web.archive.org

There are three main dimensions to the solution to your problem. The first is to learn to find happiness alone. This is not a game, but something you can really attain. This is usually the most powerful antidote to the Neediness, Love-Junkie part.

Second, you need to keep working with your own Negative Thoughts on paper, using the Daily Mood Log.

Finally, it is no game. You have to really learn that you don't need the other person. Once this dawns on you, the other person will suddenly need you.

Someone has to do the chasing, and someone has to be chased. When someone sense that you care for them, but genuinely do no need them, it instantly changes the dynamics.

Paradoxically, it is a game. People only want what they can't get, and they never want what they can get. You have to learn to play the game to win.

I can't believe you really did the wilderness trek. It's great! However, it isn't clear that you got any mood lift from it. I hope you did.

I always wanted my Love Junkie patients to go on an outward bound type of camping trip, but none ever did. You are the first! I will be eager to see if it proves helpful to you.

I don't go in for all the same jargon, such as "inner child," but if you like that concept, then why not?

Finally, you are putting out a great deal of effort to help yourself, doing the reading, doing the homework, trying the written exercises. You deserve enormous credit for this. My research indicates that people like yourselves who really follow up and try the different methods are the ones who make the greatest gains.

Tags: psychology, dating

Job interviews

Sat, 04 Nov 2006 16:51:46 GMT

clipped by: deanknows

Clip Source: web.archive.org

You say it's not genuine to add a comment that it's important for you to be able to contribute to their firm. Why is this not genuine? Are you saying that in reality, it is not important for you to be able to contribute to their firm, and all you care about is the salary?

I'm confused about this issue, and it seems very fundamental to me. If you can't genuinely tell them you want to contribute to their firm, then why should they hire you? I would personally never hire someone unless I was convinced they liked me and my company, and wanted to become a part of the team and to contribute to our common goals.

I'm probably not grasping what you're trying to say, but I've heard you say the same thing many times before. You've told me, essentially, that you're primarily interested in what they can do for you, and not vice versa.

In my opinion, the secret of sales is to see the world through the eyes of the other person. People operate from self-interest primarily. If you don't take into account their needs and feelings, I think you will not be very successful in your attempts to get a job, or to persuade the other person to your point of view in any situation.

When someone says, "What salary are you looking for," I still prefer my original answer, along these lines:

I understand the range for this position is $25,000 to $30,000 (or whatever it might be). Anything in that range would be great from my perspective. What I really want is to find a group of people I like, and to have a job where I can learn and make a contribution.

If I'm excited about my work, and if your colleagues like me and the work I do, then I have no doubt that salary issues will take care of themselves.

I've heard great things about your company, and I appreciate this opportunity to interview here and to learn more about what you're doing.

Tags: jobs, psychology, interview

Work anxiety

Sat, 04 Nov 2006 16:35:26 GMT

clipped by: deanknows

Clip Source: web.archive.org

When I started my practice, I used to get nervous on Sunday nights because of my thoughts, "how can I help these people on Monday morning? They have real problems and I don't really know anything/"

These thoughts seemed very real and compelling and they made me feel nervous. But by half way through Monday morning, I would discover that things went fine and my anxiety would go away.

Here is yet another angle to consider. You have the perception that you are not doing an adequate job at work. There may be some things you are doing well and some things that need improvement. This would not be so surprising. All human beings have deficiencies, including your guru! Some of my patients have learned to ask their bosses each week for feedback about one or two things they are doing well and one or two things that need improvement. The key is to respond non-defensively when you get some criticism about areas needing improvement.

Example. Let's say I asked you for criticism about my Ask the Guru page. Let's say you said, "well, Burns, some of your answers are long-winded and boring!" Then I would say, "You're right! (disarming technique) Good point. (stroking) It sounds like I need to make the answers shorter and punchier. (disarming) Thanks! (stroking)." Some of my patients have used this with their bosses with excellent results.

Tags: anxiety, depression, psychology

Changing behavior and attitude

Sat, 04 Nov 2006 05:12:38 GMT

clipped by: deanknows

Clip Source: web.archive.org

There is a chapter in Feeling Good on how to handle criticism. The two methods I recommend involve 2) the disarming technique (finding truth in the criticism) and 2) stroking (something complimentary or respectful to the person who criticizes you.). These techniques are also described in Chapters 18 - 22 of the Feeling Good Handbook.

The approaches I recommend--changing your basic attitudes, and learning new ways to communicate with others, will take time and effort to learn. There is a good bit of reading, and a lot of written exercises that are crucial in the learning process. Some people are looking for quick fixes! They feel like they shouldn't have to put in the necessary time and effort. But if you do decide to put in the effort, you may find these ideas can be well worth it. They have made a huge difference in my own life.

Tags: psychology, depression, anxiety

Overcoming procrastination

Sat, 04 Nov 2006 04:35:58 GMT

clipped by: deanknows

Clip Source: web.archive.org

In your case, your compulsion to analyze the causes of your problem�e.g., �Where does this all come from,��IS the problem. If we were working together in therapy, I would not tolerate that type of dialogue, but would encourage you to focus on one specific moment when you want help.

If you did not like this, I would simply refer you to another therapist who would be more content to talk about the origins of things, on the assumption that someone knows what the causes or, and on the assumption that this type of analysis of the origins will somewhat lead to a cure.

But nearly everyone who focused on changing their life at ONE SPECIFIC MOMENT did experience rather dramatic improvement and sometimes even a fairly profound personal transformation.

In your case, you might select one moment when you would like to overcome your procrastination and do something productive.

I remember a man I once treated who was a hoarder and a procrastinator. He kept insisting he just COULDN'T get started on some task he'd been putting off, and asked if I could help him.

I asked him what was the first thing he'd have to do. He said he'd have to walk over to his desk and sit down.

I asked if he needed any help with that. As it turned out, he didn't.

Then I asked what the second thing was. He said he'd have to pick up a pen.

I asked if he needed any help with that. As it turned out, he could do this quite easily.

We continued with several of the steps. As it turned out, there wasn't anything he needed my help with.

Now, you might say, "Well, I need help doing one of the more important steps, rather than all the little distractions and preliminaries I always get lost in."

I might say, "So what is one specific bigger thing you'd like to do? If you were well, and didn't have this problem, what, exactly, would you do, and what time of day would you do it on?"

Once you spelled out specifically what it was that you wanted to do, I would ask if you needed help with it.

Tags: procrastination, psychology, depression

How CBT works

Fri, 03 Nov 2006 22:22:20 GMT

clipped by: deanknows

Clip Source: web.archive.org

When you say you can figure out what the "rational thought" should be, I don't think you have really comprehended how CBT works. In CBT, one does not try to impose "rational thoughts" on anyone. Instead, you use a wide variety of methods to put the lie to your own Negative Thought.

Keep in mind, too, that this is a written exercise, and it can be useful to do it in a step-by-step way, as I outline in the Feeling Good Handbook and other books. Often, people try to do it in their heads. In my experience, this doesn't work. At the same time, some people resist doing the written exercises. They want to talk and ruminate, but don't roll up their sleeves and get to work.

This is unfortunate. I published an article recently in one of the psychology journals on the impact of the written homework on recovery from depression. We showed, in two clinical samples, that the homework assignments had a large causal effect on recovery.

The findings indicate that people who did the written assignments improved a great deal, on average, and most of those who refused to do the homework assignments failed to improve. In spite of this powerful evidence, it is interesting that many depressed and anxious individuals still resist doing the systematic self-help assignments.

Of course, there are many alternative approaches that do not require the written homework. The psychodynamic methods you have tried would be one example. My experience as a psychiatric resident was similar to yours, by the way. The patients I treated with those methods failed to improve. That was one reason I developed an interest in CBT.

Tags: psychology